Healthland Guide: Fast Facts About Malaria

Actor George Clooney announced on Jan. 20 that he had recently beaten his second bout of malaria, which he had contracted during a diplomatic trip to Sudan. His publicist told the Washington Post that he says his experience shows how access to medication can turn “the most lethal condition in Africa” into “a bad 10 days instead of a death sentence.”

Want to know more about the otherwise pervasive disease that is so uncommon among Americans? Some fast facts:

What is it?

Malaria is caused by Plasmodium parasites that are carried and spread from human to human by female Anopheles mosquitoes.

The World Health Organization (WHO) explains:

Transmission is more intense in places where the mosquito is relatively long-lived (so that the parasite has time to complete its development inside the mosquito) and where it prefers to bite humans rather than other animals. For example, the long lifespan and strong human-biting habit of the African vector species is the underlying reason why more than 85% of the world’s malaria deaths are in Africa.

When transmitted to a new host, Plasmodium sporozoites travel to the liver to mature. Once in the liver, they differentiate and release daughter organisms called merozoites into the blood to infect red blood cells, within which they multiply further.

As the original host cells rupture, the parasites periodically invade fresh red blood cells, causing waves of symptoms like high fever, chills, diarrhea, vomiting, headaches and profuse sweating. The first symptoms typically emerge 10 days to 4 weeks after infection, but have been known to appear as early as 8 days or up to a year later.

With two types of malaria parasites, a dormant stage called hypnozoites can persist in the liver and cause relapses by invading the bloodstream weeks or years after infection.

Untreated malaria can be fatal. It kills more than 1 million people each year, 90% in sub-Saharan Africa. The WHO reports that malaria accounts for 20% of all child deaths in Africa, and that one African child dies of the disease every 45 seconds.

Malaria is endemic to 108 countries. There are high rates of transmission in Southeast Asia, Amazonian regions of South America and many island nations in the South Pacific, including Papua New Guinea, as well as sub-Saharan Africa. Malaria was eradicated in the United States in the 1950s, but about 1,500 cases are reported in the U.S. each year, usually acquired during travel to malarial areas. The Centers for Disease Control and Prevention (CDC) has a useful map that shows the distribution of malaria infection.

How do you treat it?

Malaria must be treated immediately upon diagnosis. The type of treatment will depend on the species of malaria parasite, whether the patient has an uncomplicated or severe form of the disease, whether the patient is pregnant, and where the patient acquired the disease, which will tell doctors the likelihood of the parasite’s drug resistance.

You can take anti-malarial drugs before and after traveling to areas where malaria is prevalent. Get a prescription well in advance, because treatment may begin up to 2 weeks before you travel, and continue for a month after your return.

Commonly prescribed drugs for people traveling to South America, Africa, the Indian subcontinent, Asia and the South Pacific include: mefloquine, doxycycline, chloroquine, hydroxychloroquine and Malarone (a combination of atovaquone and proguanil). The type of medication recommended will depend on the known drug resistance of the parasites in the areas you are planning to travel.

During your travels, you should use insect repellent, wear long sleeves and pants and use insecticide-treated bednets.

For more, see the CDC’s chart on the pros and cons of various anti-malarial drugs.

Which other bold-faced names had it?

Eight U.S. presidents including George Washington and John F. Kennedy have suffered from malaria. Washington contracted it in Virginia in 1749 and had five recurrent bouts on record. JFK contracted the disease while serving in the Navy during World War II, and Theodore Roosevelt returned from a trip to Brazil with the illness.

As far as modern celebrities go, in addition to George Clooney, the Washington Postreports that actor Jeremy Piven and CNN anchor Anderson Cooper have both suffered from the disease.